소아치과 전문의 인력 현황 및 공급 적정성에 관한 연구 – 급여 진료 항목을 기준으로

임여원,채용권,이고은,남옥형,이효설,최성철,김미선 대한소아치과학회 2023 大韓小兒齒科學會誌 Vol.50 No.3

The aim of this study was to identify the current state of pediatric dentists, evaluate the adequacy of pediatric dentist supply and demand, and find out the perception of all pediatric dentists on the current state of pediatric dentists and policy establishment. An Online survey was conducted among pediatric dentists. The questionnaire was subdivided into ‘general characteristics’, ‘number of dental treatments and working days per year’, ‘proportion of covered services’, ‘perceptions of supply and demand of pediatric dentists’. Through the Korean Academy of Pediatric Dentistry, the Health Insurance Review and Assessment Services, the National Health Insurance Service (NHIS), and the Korean Statistical Information Service, the current state of pediatric dentists, the number of claims for covered services, and the decrease in births per year were investigated. Dental clinics claiming to be pediatric dentistry reached half of all medical institutions, but only 3.78% of pediatric dentists actually worked. 61.36% of all pediatric dentists were concentrated in the metropolitan area, showing a national imbalance. Although the population of children and adolescents have continuously decreased over the past 20 years, the number of NHIS-covered services has shown a continuous increase. Over the past 10 years, the optimal supply of pediatric dentists has been maintained at around 4,000. According to the analysis, 92.15% of pediatric dentists thought that it was necessary to prepare policies and support measures at the government level. This study is expected to be used as basic data for establishing a demand estimation method for pediatric dentistry specialists in the future. 본 연구의 목적은 소아치과 전문의 인력 현황을 파악하고 만 19세 미만 환자의 연간 치과 이용량과 소아치과의사의 진료 생산성을 바탕으로 소아치과 전문의 인력 공급의 적정성을 평가하는 것이며 향후 정책 수립을 위한 의견을 알아보고자 하였다. 소아치과의사들을 대상으로 온라인 설문조사를 통해 ‘일반적인 특성’, ‘연간 진료 횟수 및 근무 일수’, ‘급여진료 비율’, ‘전문의 수급 인식’에 대한 응답을 수집하였다. 대한소아치과학회, 건강보험심사평가원, 국민건강보험공단, 국가통계포털을 통해 소아치과의사 현황 및 진료 청구 횟수, 연간 출생아 수 감소 등을 조사하였다. 진료과목을 소아치과로 표방하는 치과는 전체 의료기관의 절반에 달했지만 실제 소아치과 의사가 근무하는 곳은 3.78%에 불과했다. 전체 소아치과의사의 61.36%가 수도권에 집중된 지역적 불균형을 보였다. 지난 20년 동안 소아청소년 인구는 지속적으로 감소했지만, 급여 진료 청구 횟수는 지속적으로 증가하고 있다. 지난 10년간 소아치과 전문의 적정 공급량은 4,000명 내외로 유지되었다. 소아치과 의사의 92.15%가 정부 차원의 정책 마련과 지원 방안이 필요하다고 생각하였다. 본 연구가 향후 소아치과 전문의 수요예측 방법 확립을 위한 기초자료로 활용될 수 있기를 기대한다.

일반 진료 치과의사와 소아 진료 치과의사의 스트레스 유발 요인과 직무 스트레스 정도에 대한 연구

김승현,이제식 대한소아치과학회 2022 大韓小兒齒科學會誌 Vol.49 No.4

The purpose of this study was to compare factors causing stress in pediatric and general dentists when treating pediatric patients and to evaluate their overall occupational stress level. A total of 191 dentists participated in the online survey, consisting of 66 pediatric dentists and 125 general dentists. The questionnaire was conducted using Google Form. Both groups were stressed due to poor cooperation of patient and caregiver, uncertain prognosis of treatment, and low cost of pediatric dental treatment. The pediatric dentists felt relatively high stress due to poor cooperation from caregivers and an uncertain prognosis of treatment (p < 0.05). Overall occupational stress was high in both groups in the order of patient, time, job environment, and income-related stress, and the degrees of pediatric dentists were lower than general dentists. Among the 3 sub-factors of occupational burnout, more than 98% of both groups showed burnout in “depersonalization”, and more than 69% of both groups showed burnout in “emotional exhaustion”. Both groups showed a low burnout rate in “reduced sense of accomplishment” and pediatric dentists showed a higher sense of accomplishment than general dentists (p < 0.05). This study showed that both groups were under high occupational stress due to various factors, and efforts were required to relieve stress.

소아 진료 치과의사 및 성인 진료 치과의사의 근골격계 통증 비교 설문 조사

김기민,이제식,김현정,남순현,Kim, Gimin,Lee, Jaesik,Kim, Hyunjung,Nam, Soonhyeun 대한소아치과학회 2021 大韓小兒齒科學會誌 Vol.48 No.2

이 연구는 소아 진료 치과의사와 성인 진료 치과의사의 근골격계질환 발생관 관련되는 요인을 알아보고자 하였다. 최근 1년 동안 근무를 하는 치과의사 중 온라인을 통해 설문 조사에 참여한 43명의 소아 진료 치과의사와 66명의 성인 진료 치과의사, 총 109명의 설문 조사지를 분석 평가하였다. 소아 진료 치과의사 및 성인 진료 치과의사 모두 목, 어깨, 손목, 허리에서 주로 근골격계 통증 및 불편을 호소하였다. 소아 진료 치과의사는 치료 시 주로 허리에서 불편한 자세로 통증을 느끼며 진료하였다. 소아 진료 치과의사의 약물진정치료시에는 목과 어깨에서 통증을 더 많이 느꼈다. 근골격계 통증의 예방을 위한 규칙적인 운동 및 스트레칭은 허리에서만 통증을 경감시키는 것으로 나타났다. The purpose of this study was to investigate the characteristics related to the musculoskeletal disorders in pediatric dentists and general dentists. This study was conducted based on the survey results of a total of 109 dentists who have been working for the last year. Forty - three pediatric dentists and 66 general dentists were surveyed through online survey tool. Both pediatric dentists and general dentists mainly complained of musculoskeletal disorders in the neck, shoulders, wrists, and back. Most pediatric dentists usually suffered from back pain due to their unbalanced posture while giving dental treatments. Pediatric dentists in sedative treatment felt more pain in particular part of their body, such as neck and shoulder. Regular exercise and stretching for the prevention of musculoskeletal disorder have been shown to mainly relieve pain in the back but no other parts in their body.

한국에서 소아전문 치과의원의 지역분포 및 진료패턴

채종균,송지수,신터전,현홍근,김정욱,장기택,이상훈,김영재 대한소아치과학회 2020 大韓小兒齒科學會誌 Vol.47 No.1

The number of pediatric dental clinics has been increasing due to the development of dentistry and changes in public awareness of professional dental care for children. The purpose of this study was to investigate the present status of pediatric dental clinics in Korea in several respects, including regional distribution. There were 343 pediatric dental clinics (1.91%) among 17,917 dental clinics in Korea. 248 out of 343 private practitioners were board certified pediatric dentists. Of 248 board certified pediatric dentists, 25 displayed the specialty in their clinics’ name. Gyeonggi occupied largest share of the total pediatric dental clinics in Korea, followed by Seoul and Busan. Gangnam-gu occupied largest share of the total pediatric dental clinics in Seoul. Out of all pediatric dental clinics in Korea, 78.7% was run by only one dentist. 90.9% of pediatric dental clinics didn’t do night clinic on weekdays and 26.5% was open until after 15:00 on Saturday. 1956년 한국에 처음 소아치과학교실이 창설되었고, 1992년 한국 최초의 소아전문 치과의원이 등장하였다. 치의학의 발전과 소아치과에 대한 대중의 인식 변화로 인해 소아전문 치과의원은 점점 더 증가하고 있다. 이 연구의 목적은 지역 분포를 포함한 여러 측면에서 한국의 소아전문 치과의원의 현황을 조사하는 것이다. 한국에 17,917개의 치과의원 중 소아전문 치과의원은 343개이고, 1.91%를 차지하였다. 343명의 소아전문 치과의원 개원의 중 248 명이 소아치과 전문의였다. 소아치과 전문의 248명 중 25명이 전문의를 표방하여 개원하고 있었다. 16개의 시도 중 경기도에 소아전문 치과의원이 가장 많았고, 33.5%를 차지하였다. 서울과 부산이 그 뒤를 이었다. 서울의 25개 구 중에서는 강남구에 소아전문 치과의원이 가장 많았고, 유소년 10만명당 소아전문 치과의원 수도 강남구에서 제일 높았다. 소아전문 치과의원의 90.9%는 평일 야간진료를하지 않았고, 26.5%는 토요일에 15시 이후에 문을 닫았다.

치과의사의 아동 학대 및 방임에 대한 인식과 신고 의무 태도

장다혜,채용권,이고은,남옥형,이효설,최성철,김미선,Da Hyeo Jang,Yong Kwon Chae,Ko Eun Lee,Ok Hyung Nam,Hyoseol Lee,Sung Chul Choi,Mi Sun Kim 대한소아치과학회 2023 大韓小兒齒科學會誌 Vol.50 No.1

In this study, the recognition of child abuse and neglect (CAN) and reporting attitudes of general dentists and pediatric dentists in Korea were estimated. A survey was conducted among dentists working at clinics or university hospitals, including interns and residents at dental hospital training institutions. The questionnaire, consisting of 32 questions and detailed questions, subdivided into 'general characteristics of respondents', 'CAN', 'CAN report', 'laws to CAN', 'countermeasures against CAN'. The survey was conducted using a messenger, and 176 respondents' answers were analyzed. The recognition of CAN showed high scores in the order of physical abuse, neglect, and emotional abuse. The positive attitude toward reporting CAN had a higher score than the negative attitude. Of the total respondents, 19 said they reported child abuse, and 18 said they were suspected of child abuse but hesitated to report it. Among the laws related to CAN, the protection measures for CAN reporters and the protocol for CAN showed low awareness. Since then, they have wanted to know how to find abused children and how to deal with them in education. This study is expected to be used as data to improve dentists' awareness and consciousness of CAN in the future.

Evaluating the Accuracy of Artificial Intelligence-Based Chatbots on Pediatric Dentistry Questions in the Korean National Dental Board Exam

정윤선,채용권,김미선,이효설,최성철,남옥형 대한소아치과학회 2024 大韓小兒齒科學會誌 Vol.51 No.3

This study aimed to assess the competency of artificial intelligence (AI) in pediatric dentistry and compare it with that of dentists. We used open-source data obtained from the Korea Health Personnel Licensing Examination Institute. A total of 32 item multiple-choice pediatric dentistry exam questions were included. Two AIbased chatbots (ChatGPT 3.5 and Gemini) were evaluated. Each chatbot received the same questions seven times in separate chat sessions initiated on April 25, 2024. The accuracy was assessed by measuring the percentage of correct answers, and consistency was evaluated using Cronbach’s alpha coefficient. Both ChatGPT 3.5 and Gemini demonstrated similar accuracy, with no significant differences observed between them. However, neither chatbot achieved the minimum passing score set by the Pediatric Dentistry National Examination. However, both chatbots exhibited acceptable consistency in their responses. Within the limits of this study, both AIbased chatbots did not sufficiently answer the pediatric dentistry exam questions. This finding suggests that pediatric dentists should be aware of the advantages and limitations of this new tool and effectively utilize it to promote patient health.

소아치과 전문의 수요추계 모형에 관한 고창

이문영,정태성,김신 대한소아치과학회 2007 大韓小兒齒科學會誌 Vol.34 No.1

현재 우리나라는 치과의사 전문의제도가 도입되고 저출산 고령화 사회로의 급속한 이행 등 여러 이유로 소아치과 전문의 수급에 관한 연구가 절실한 실정이다. 본 연구는 소아치과 전문의 수요추계에 적합한 모형을 모색할 목적으로 의료인력 수급에 관한 타 분야의 기존 연구들을 고찰하여 다음과 같은 결과를 얻었다. 1. 소아치과 전문의의 수요추계는 의료수요에 근거한 방법을 적용하는 것이 적절할 것으로 사료되었다. 2. 추계 모형에 필요한 독립변수로는 크게 유병율, 수진율, 의뢰율, 출산율, 생산성, 연간 진료일수 등이 있었으나, 이러한 변수들에 대입하기 위한 기초자료가 부족한 것으로 나타나, 이를 보완할 설문조사와 전문가 의견조사가 필요할 것으로 판단되었다. 3. 독립변수는 각 특성에 적합한 회귀모형을 설정하여 추계하고, 가중치를 주어 추계 모형에 반영해야 할 것으로 판단되었다. 향후 추계 모형에 대입하기 위한 독립변수의 생성과 추계연구, 전문가의 검증과정이 추가로 필요하며 이를 토대로 소아치과 전문의 수요를 추계하여야 할 것으로 사료된다. The supply and demand planning of the pediatric dentists is earnest, because of the start of the dental specialist system on 2008 and aging society with low fertility. Therefore in order to develop the model, that is adequate to estimate demand for the pediatric dentists, a studies on the supply and demand planning of other health manpower were reviewed. The obtained results were as follows; 1. The health demand method was appropriate for demand estimation of the pediatric dentists. 2. There was independent variables needed for demand estimation model: prevalence, utilization rate, referral rate, fertility rate, productivity, annual working days, and so on. 3. Since statistical data for application of these variables was insufficient as result of searching, questionnaire researching and discussion of specialist may be necessary. 4. Each independent variables should be inducted into an equation by using a adequate regression model and then estimated.

소아치과 수련 여부에 따른 수도권 지역 치과의사의 소아 환자 행동 조절 및 진료 현황에 대한 비교 연구

김용수,김진태,이상훈 大韓小兒齒科學會 1996 大韓小兒齒科學會誌 Vol.23 No.1

Recognition and attitude of pediatric patients on dental treatment are formed by many factors. Combinations of characteristics of each patient, direct and indirect dental and medical histories, other circumstances including parent's attitude, and especially attitude and the method of behavior management of dentist are acted together into a child. So, complicated reaction such as fear, anxiety, resistance and timidity can be occurred. Questionnaires about behavior management and present treatment status of child patients in Seoul area, 113 returned questionnaires(trained ; 49, untrained ; 64) were analyzed and and N₂O-O₂ inhalative seadtion showed significant positive correlation(P<0.05). 1. Pediatric trained dentists group treated more pediatric patients than untrained dentists(P<0.05) and showed significant easiness for the treatment of pediatric patients compared to adult patients(P<0.05). 2. The percentage of treating mental retarded patients(P<0.1) and medically compromised patients(P<0.01) by themselves took higher rate in pediatric trained dentist group. 3. Both groups favored behavior management on the basis of interpersonal relationship rather than physical restraint or using sedatives. In the items on Tell-Show-Do(P<0.05), Voice Control(P<0.05), Positive Reinforcement(P<0.05), applying Pedi-Wrap(P<0.01), Pediatric trained dentist group showed significantly higher rate, but rather showed lower rate in uncontinuing or delaying treatment(P<0.05). 4. In the Pediatric trained dentist group, rate of referring to other clinic due to behavior problem was significantly low(P<0.05). 5. Between experience of pediatric trained dentist and frequency of drug-using-sedation and N₂O-O₂ inhalative sedation showed significant positive correlation(P<0.05). 6. Among experience of pediatric trained dentist, referring clinic and route of acquiring behavior management method show significant posotive correlation(P<0.05).

소아치과의사를 위한 심폐소생술과 소아고급생명구조술

김종빈 대한소아치과학회 2017 大韓小兒齒科學會誌 Vol.44 No.2

Cardiopulmonary resuscitation (CPR) is an emergency treatment that stimulates blood circulation and breathing when the function of the heart stops or stops breathing. CPR can be divided by basic life support (BLS) and advanced life support (ALS). BLS involves the use of chest compression to force the blood flow to the main organs, rescue breathing to improve the breathing to the respiratory failure patient and the use automated external defibrillator (AED). The categories of advanced life support include advanced cardiovascular life support (ACLS) for adult and pediatric advanced life support (PALS) for children. In the treatment of dental care for children, which is extremely difficult to deal with, and for a variety of reasons, the use of sedation is considered to treat the children who are unlikely to cooperate with dentistry. This is why there is an increasing possibility of an emergency situation involving cardiac arrest. PALS includes the BLS, and it presents a systematic algorithm to treat respiratory failure, shock and cardiogenic cardiac arrest. In order to manage emergency situations in the pediatric dental clinic, respiratory support is most important. Therefore, mastering professional PALS, which includes respiratory care and core cases, particularly upper airway obstruction and respiratory depression caused by a respiratory control problem, would be highly desirable for a physician who treats pediatric dental patients. Regular training and renewal training every two years is necessary to be able to immediately implement professional skills in emergency situations. 심폐소생술(cardiopulmonary resuscitation, CPR)은 심장의 기능이 정지하거나 호흡이 멈추었을 때 인공적으로 혈액을 순환시키고호흡을 보조해 주는 응급처치이다. 심폐소생술은 기본생명구조술(basic life support, BLS)과 전문소생술(advanced life support, ALS)로 나눌 수 있다. 기본생명구조술은주요 조직으로 혈류 공급을 강제적으로 하기 위한 흉부압박과 호흡정지 환자에게 구조호흡(rescue breathing) 그리고 심실세동을 개선해 주기 위한 자동제세동기(automated external defibrillator, AED)이 포함된다. 전문소생술의 범주는 성인을 대상으로 하는 고급생명구조술(advanced cardiovascular life support, ACLS)과 소아를 대상으로 하는 소아고급생명구조술(pediatric advanced life support, PALS)이 있다. 치과 치료에 극심한 공포를 가지며, 여러 이유로 치과 진료에 협조를 얻기 어려운 소아를 대상으로 하는 치료환경에서는 약물을 이용한 진정법이 고려된다. 이는 심정지를 포함한 응급상황이 발생할 가능성이 증가하는 이유가 된다. 소아고급생명구조술은 기본생명구조술을 포함하며, 심정지에 이를 수 있는 원인을 호흡, 순환장애 그리고 심인성으로 나누어 대처하는 체계적인 방법을 제시한다. 소아는 성인에 비해 심인성의 원인은 낮지만, 해부학적인 약점으로 인해 호흡이나, 순환장애에 의한 심정지의 가능성은 높다. 따라서, 스트레스를 많이 받은 아이를 치료하거나 진정법을 시행하는 소아치과의사는 소아고급생명구조술을 익힘으로써 응급상황에 적절히 대처할 수 있는 역량을 갖출 수 있으리라 사료된다.

소아치과 의사와 행동조절방법에 대한 보호자의 선호도 조사

박수진,정태성,김신 大韓小兒齒科學會 2002 大韓小兒齒科學會誌 Vol.29 No.2

본 조사는 소아치과 환아 보호자들이 소아치과 의사와 행동조절방법에 대해 어떤 인식을 가지고 있는가를 파악할 목적으로 시도되었다. 조사는 6개월간 부산대학교 병원 소아치과에 내원한 초진단계 환아 보호자들을 대상으로 하였다. 설문 조사는 초진시, 그리고 1개월 후의 2회에 걸쳐 이루어졌다. 선호도 조사는 크게 2가지로 대별하여 의사에 관한 부분으로 의사의 성별, 가운(gown)의 색, 안경착용에 관한 선호도를 조사하였고, 행동조절방법에 대한 조사로는 진료실에서의 보호자 분리, 진정요법, 음성조절, 신체속박장비에 관한 부분들이었다. 조사결과, 다음과 같은 점들을 알 수 있었다. 1. 소아치과 의사의 성별에 대한 보호자 선호도는 나타나지 않았다. 2. 의사의 안경착용이 어린이의 불안에 미치는 영향에 대해서는 별다른 의식을 가지고 있지 않았으나, 의사의 흰 가운데 대해서는 다양한 견해를 나타내었다. 3. 진료실에서의 보호자 분리에 대해서는 대부분 반대하였다. 4. 주요 행동조절 방법들에 대해서 대부분의 보호자들은 수용하는 편이었다. 5. 1차 조사결과와 2차 조사결과 간에는 유의한 차이가 없었다. The purpose of this survey was to investigate parental recognition and preference on pediatric dentist and their behavior management technique. The subjects were the parents of new children visiting the Department of Pediatric Dentisrty, Pusan National University Hospital for 6 months. The questionnaire was performed over 2 times : at 1st visit and 1 month after that. The parental preference about pediatric dentist - one's sex, color of gown and glass-wearing - and about behavior management technique - parental separation, oral sedation, voice control and physical restraints-were asked through the questionaire and obtained the results were as follows: 1. The preference on sex of dentists was not shown. 2. The parents recognized not so close relation between glass-wearing and children's anxiety level, but on col-or of gown, showed various opinions. 3. Most parents opposed to the separation from their children in operatory. 4. For the behavior management technique, parents accepted generally. 5. There was no siginficant difference between the first and second survey.